AN OPEN LETTER TO RODRIGO R. DUTERTE President, Republic of the Philippines

World Experience and New Scientific Findings:Relevance for Containing COVID-19

18 April 2020

Dear Mr. President,

Given the incomplete and sketchy scientific and global information available to you then, you understandably had no real choice but to lock down the entire country in an attempt to control COVID-19 infections and deaths. Your quick and decisive action gave the nation some breathing space in the face of the unknown. However, in the meantime, new challenges have surfaced, needing to be addressed urgently.

As you acknowledged from your recent addresses to the nation, you are now caught in the middle of a cruel choice: Saving lives or saving the economy?

One way to express this with more elaboration is as follows. In the attempt to save lives (from an enemy that cannot be killed by bullets – your comparison), shall you continue to collapse the economy, generate mass unemployment and spawn starvation and social unrest that ironically may result in more misery and deaths than the disease itself? Shall you continue to save lives and destroy the economy in the process, including endangering government stability itself with a significant shrinkage of its tax base, among others?

You have recently mentioned (April 9) that government has only two months worth of funds to fight the pandemic. What if, as scientists are starting to warn heads of state around the world, a second wave will hit the nation, a side-effect of the lockdown and flattening the curve approach? We are already beginning to witness this in China.

What shall we all do then?

Mr. President, what if you can have it both ways: save Filipino lives while at the same time save Philippine society and its economy from self-imploding? Will you be open to a scientific approach that can achieve this balance?

Reason for Writing

Encouraging rapid developments in the world, especially in the field of scientific understanding and innovative societal approaches, are showing that there can be an approach that can save lives WITHOUT necessarily destroying Philippine society and its economy. (For details, kindly see attached Briefing Paper.)

Prominent mainstream scientists and experts on viral pandemics, including a Nobel Prize winner, have analyzed the global experience in controlling the viral pandemic. And they are coming up with very interesting ways of controlling the virus without compromising the economy and society.

Overview of the Current Philippine Experience

• Current health statistics of the Philippines strongly show that there is a reason for grave concern. (All Tables and Figures cited in the overview are found in the attached Briefing Paper.)• Even as the cumulative cases per day are increasing, the number of new cases per day in the Philippines is tending towards decline as compared with previous days. This is already being hinted at in Table 1 and Figure 1 of the attached Briefing Paper. (Table 1 and Figure 1)• This conclusion is more clearly seen when one looks at the growth rate of new cases per day. It is definitely declining. (Table 2 and Figure 2 )• The Case Fatality Rate (CFR) or death rate of the Philippines is also decreasing significantly. (Table 3 and Figure 3 below)• Furthermore, our deaths per capita from COVID-19, is one of the lowest in the world. (Table 5 in comparison with Table 6.)• These results and the conclusion arising from the Figures and Tables below serve as necessary reality check to the daily figures being announced by DOH and the media. In fact in your televised Cabinet Meeting on April 9, the Secretary of DOH acknowledged the declining rate of infection.• The figures from DOH, which then gets press coverage, overstate the number of infections for many reasons, including the use of tests resulting in large numbers of false positives. These inaccurate test results create unnecessary panic and hysteria among our citizens. (See Briefing Paper for scientific evidence of a similar phenomena around the world.)• The declining rate of new cases and low death rates (CFR) indicate that the virus behind COVID-19 is not a virulent as feared. At most it is a stronger version of the flu as scientists from all over the world are discovering.• A more precise elaboration of the death rate data enabled Nobel Prize winner, Dr. Michael Levitt, to successfully and accurately predict the decline of the pandemic in China. (See attached Briefing Paper.)• The Philippines has suffered more deaths from pneumonia and flu when compared with the deaths from COVID-19 for the same period of time. (Table 4)• Yet we never locked down our society every time there was a pneumonia or flu epidemic.• The reason for the declining growth rates is that health authorities around the world understand the huge importance of natural individual immunity and collective (“herd”) immunity in stopping the virus. (See Briefing Paper.)• Collective immunity is on the way in many countries. This means that the collective natural immunity of people can withstand viral attack, as manifested in the huge numbers of humans who have not succumbed to COVID-19. (See Briefing Paper.)• The lockdown and social distancing of the past weeks may have helped achieve the promising results above.• However, continued lockdown and social distancing will predispose the country to another epidemic wave of the COVID-19. (To be explained more fully below.)• This will worsen the economic and societal impact that has already resulted in massive unemployment, decline in the GNP/GDP, and a likely increase in poverty and increasing social unrest which could result in even more deaths due to loss of livelihood, starvation, and stress.

In short, Mr. President, there is really no need to extend the tight lockdown any further. Instead we can build upon existing gains you have achieved and refine it with a sister approach: Precision Quarantine and Immunity (PQI) approach, a scientifically more precise version of the “selective quarantine” alternative being proposed by many sectors, especially the business sectors.

Regarding lockdowns, kindly see Appendix A of Briefing Paper on the Open Letter of Prof. Dr. Sucharit Bhakdi to German Chancellor, Angelina Merkel on 26 March 2020. Dr. Bhakdi is a world renowned scientist and expert in pandemics and is one of Germany’s most cited scientists in the field of medicine.

Based on the updated scientific understanding of the virus and the experience of nations, we can promulgate PQI’s seven basic principles that would enable you, your team and concerned citizens to save lives and regenerate our badly damaged society especially our economy.

The seven principles of PQI are based on the medical understanding that the gravity of a pandemic depends on: a) the virulence of the pathogen; and b) the prevailing strength of the immune system of countries. The virus spreads faster when the immune systems of people are weak and/or compromised by pre-existing illnesses. (Italy and Spain are the prime examples of this.)

We gathered these seven principles from the on-going experience of nations in dealing with the COVID-19 pandemic.

The seven principles of Precision Quarantine and Immunity (PQI) are:

1

Protect Risk Groups especially the elderly.

2

Self-Isolate oneself immediately if one has cough, fever or any symptom of illness.

3

Re-open schools for children to hasten achievement of herd immunity.

4

Allow teenagers and the working population, in the various institutions, to continue their normal lives, provided they follow safe distancing and hygienic practices.

5

Re-open regions, provinces, cities, towns, barangays, and institutions on the basis of their low risk densities.

6

Instruct all age groups on how to strengthen their immune system.

7

Install a communication, monitoring and enforcement system, to ensure that this new approach works. This would include occasional randomized antibody testing, using the most accurate tests, to determine progress towards herd immunity.

Kindly find attached a copy of the Briefing Paper that provides detailed support for all the conclusions and recommendations given above including the PQI approach and its seven Principles.

Mr. President, we now have a better scientific understanding of how to contain the not too deadly virus after all. We all truly hope that you will decide to save both lives and the stability of Philippine society including its precious economy.

106 replies on “AN OPEN LETTER TO RODRIGO R. DUTERTE President, Republic of the Philippines”

Two sides of the coin apply lockdown to barangays with high infection rate and lift quarantine to areas free of or manageable covid19 cases, other side of the coin is how prepare our finances and logistics for resurgence / 2nd / 3rd wave of pandemic? The latter we need to prepare diligently.God bless the Philippines!

Enhanced community quarantine really help a lot to prevent transmission of the disease. However, it also affects the economy. To the areas with zero case, allow those people to work especially the farmers who are really most affected with the crisis. Because of the limited movement, they could’nt sell their farm produces.

Check your numbers mr Perlas. Getting herd immunity by natural means is costly. Very very costly. We need at least 70 percent of population infected with covid for herd immunity to stop further spread of infection. 100,000,000Filipinos x 70%, equals 70,000,000 infected people. With mortality range of 1%conservative, to 5%worst case, that means 700,000 to 3,500,000 dead Filipinos 😭. Are they dispensable? The 3.5million dead? What if it’s YOU OR YOUR LOVED ONES😢
Herd immunity is good only if it’s done through the science of VACCINATION! Where mortality is none or nil! So for now, we only need PHASED WITHDRAWAL, to borrow from the military.

Thanks for your post, Mr. Canete. It is not as simple as you present it to be. My reply will come in two part. If you look closely at the website article “Antibody testing shows coronavirus infected a lot more people than previously thought”, the Case Fatality Rate (CFR) for that study is 0.12% to 0.2%. An increased number for the denominator (infected cases) means a lowering of CFR. Also the CFR assumes that the deaths (numerator #) reported are accurate and doctors are distinguishing between deaths FROM the virus and deaths WITH the virus. If not, as is the case, the latter would give inflated figures. (See Briefing Paper on CFR calculations.)

Based on the data provided in said article, CFR is actually 0.068% on the average. But let’s use the O.12% CFR in the paper but this time factoring in demographic vulnerability, those with ages between 61 years and above. This translates to 9,039,200 senior citizens or 8% of the 111,783,000 (most recent figure for RP population). Thus, at a CFR of 0.12%, we would have 10,847 seniors at risk from COVID. That would be far from the 700,000 to 3.5 million deaths you are postulating. As for the younger populations, there are very few reports. No one has come up with a CFR for children and young adults, but most talk about CFR for seniors as the vast majority of cases are with that age group. In Italy over 99% of deaths are in this age group.

[Sorry, internet so slow now. 3rd part] In addition to all these, the Precision Quarantine and Immunity (PQI) approach does not leave seniors and other vulnerable sectors alone. So the projected deaths of seniors (10K+) will even be lower. PQI aspires for collective immunity but with safeguards. (See Briefing Paper for details.) Finally, vaccines will not be the magic bullet that all are waiting for. It is one of the most contested terrains in modern medicine. The vaccine solution will be hotly contested. For example, see the book, “Plague” by Dr. Judy Mikovits, a top notch scientist on virus and vaccines.

You don’t have to look at your numbers, which you projected to be low, which may be premised on wrong or RAW statistics subject to validation.
We just have to look at the number of deaths in the US, now. It’s beyond 50k, and rising! In a very short span of time!

About 4x to 5x of that are active cases admitted to hospitals with average of 14 days hospital time! That’s a whopping 200k patients, morbid at that, admitted to ICUs! In 14 days, they stay there. IN A MATTER OF A MONTH you got this numbers. That’s a deluge to health care system.
It precludes the hospitals from managing your ordinary diseases. Deaths due to noncovid will rise! For sure! And that’s not something to set aside.
The economic cost of hospitalizing a deluge of patients is even too much for state of new york, a rich one, even as their lockdowns are now working.

Readers can decide for themselves where the truth is. You can speculate all you want but the CFR in most countries are overblown, as many scientists are beginning to point out, and most of the fatalities are deaths WITH COVID-19, not FROM COVID-19 as documented in the Briefing Paper and a number of articles in this website. This will be my last post on this thread. There are more urgent things to take care of.

Accurate CFR computations and interpretations are the province of MD epidemiologists. Leave it to them, if we want the “accurate “ data that a non-md statisticians and economists would desire. For the current “eyeballing” of things, the CFR is around 6.9 percent world average. 203,596/2,932,000 .That’s a rough estimate, but definitely not far away from the real cfr, I’m sure. And this is even an underestimation, because more cases are found as we speak and these cases are still alive but some are expected to succumb after an average of 2weeks(active symptomtic and severe cases). Therefore, the percentage is expected to rise as time goes by. (Please follow the current world events) That’s far from minuscule number that you have come up with. Apparently, you got your assumptions/inputs wrong. It would be more prudent to consult a competent epidemiologist MD for computation and interpretation.
By the way, don’t rely on your sources that says seniors are the only deaths more 90 percent of the time. Definitely WRONG! Look at the Philippines DOH stats.

I totally agree with this approach. The risks as indicated by the US CDC are:
(1) Age >75
(2) between ages 65-74 and
(3) BMI >40 (morbid obesity)
Our country has a young demographic with an average age hovering around 25 years and an only 5.5% of the population is 65 or older (to use our definition of senior 8.6% of the population is 60 or older) (stat from PSA).

Thus stringent quarantining for the vulnerable population while allowing the vast majority of the working age population to work and allowing schools to open is a rational and reasonable targeted solution to this dilemma.

The current shotgun approach was the only solution to a problem that no one understood, but our experience to date dictates otherwise.

Quarantining only the vulnerable populations will lower the cost to the government because the government can partially pass the financial burden of this cost to families who are working.

Additionally, allowing non vulnerable populations to work and go back to school will speed up herd immunity without taxing our healthcare system.

Please do not continue to harshly imprison healthy elderly. We KNOW how to protect ourselves and we are responsible for our risks. We thank you for your great concern but we are not like children who cannot think for ourselves. Please! 24 hour quarantine every day. Many of us cannot shop for food without getting arrested, in which case we will really get exposed. You do not understand how terrible it is for those of us who have no young people in the household to go out for us. You do not understand. Think! Let us out of prison.

Not all senior citizens are weak or sick. Some of us are healthier than other younger people. My partner and i don’t have kasambahays. Our children live far from us. Home deliveries for groceries and other essentials are not efficient. What are we to do? Stay home and die?

I agree with Healthy Elderly Person totally! Some of us are healthier than the younger age groups because we know how to take care of ourselves and that’s why we have reached this phase of our lives and are still active and productive! We are not invalids so don’t sideline us!

‘this discussion here is should we “imprison” the young, less vulnerable sector together with the elderly vulnerable sector. The best of course is to “free” EVERYBODY. If that is deemed not possible, at least a compromise could be worked out the save the economy. But who will do the shopping for the elderly? That could be worked out. But my understanding is this is only for two weeks or so extension of the quarantine. I think the elderly could make that little sacrifice for the good of all. But maybe you are right, the elderly could also take EXTRA precautions for themselves short of continued self-quarantine. We are still discussing.

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very critical matter…
if our economy will collapse.. severe poverty will occur meaning more sickness & deaths the death count maybe more..
it is better to have low income generation Economy than nothing or no bussiness..
In order to help the business cguro suspend or lower the VAT to 10% for one year, the the small & medium businessmen will have spare money to cope up the losses during the lockdown, then business can continue to grow..
otherwise some or quite a number of business will opt to shut down, then there will be severe unemployment..
hindi bale smaller ang income ng government basta mag.tuloy.tuloy lng ang economy.. the President must realise that 90% of our industries belongs to small & medium company yun iba nga micro industry. ..

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At this time of crisis, profit could be sacrificed for the time beng. We are on survival mode. Employees as well as employers must be ready to sacrifice. We are saving the economy. We are worried that there might be a 2nd wave of covid-19. That is taken into account in the proposal. Let us make it work.

I agree that most if Not All of the Senior Citizens are Healthier than the Young people now!Because of the Lifestyle Most Young people do now in their daily Lives..Most young people now or even before after office Works or during their Free time they Drink Alcohol and Most of them Smoke a lot and Stay late,Palaging nagpupuyat.So with these kind of Lifestyles Our IMMUNE SYSTEM could be very Weak and we can be Vulnerable to all kinds of Diseases.While most Elderly people like me who are already Retired from employment few years ago,We have enough Rest and we are more Conscious about our Health and we have a Better LifeStyle.That’s why we are Healthier!!!Of Course it’s very important to eat Healthy foods and take Supplements everyday Specially SODIUM ASCORBATE VIT-C the Best Anti-Oxidant available today!!

I AM SURE ALL OF US NOTICED THAT IN THE LAST 3 WEEKS :WALANG KA TRAFFIC TRAFFIC ANYWHERE IN THE ENTIRE GMA!!!ANG LUWANG NG MGA KALSADA!!!AND I AM SURE IN THE MORNING WHEN WE WAKE UP,YOU WILL NOTICE THE THE COLOR OF THE SKY,IT’S SO CLEAR!VERY CLEAR :THE ABSENSE OF AIR POLLUTION!!!PARANG ANG SARAP LUMABAS NG BAHAY AT LANGHAPIN ANG FRESH AIR(But medyo natatakot din baka CORONA VIRUS ang Malalanghap natin at hindi Fresh Air?).I WOULD LIKE TO SUGGEST TO PRES DUTERTE AND THE PRESIDENTS or OWNERS OF BIG CORPORATIONS: TO MAINTAIN THIS “NO TRAFFIC CONDITIONS ON THE ROADS IN METRO MANILA;1.) LET ALL THOSE EMPLOYEES DO THEIR WORK AT HOME and DON’T HAVE TO GO TO THEIR OFFICES in Makati,BGC,ORTIGAS,Etc…etc…2.) WITH THE TECHNOLOGIES THAT WE HAVE NOW MOST EMPLOYEES CAN DO THEIR JOBS AT HOME,THAT THEY USUALLY DO IN THEIR OFFICES3.)BY DOING THESE:Maybe 50% of the Daily Traffic in GMA will be reduced and the Companies can Reduce SO MUCH ON GAS EXPENSES.3.) HOME QUARANTINE WILL NO LONGER BE A PROBLEM. 4.) AIR POLLUTIONS CAN ALSO BE REDUCED SO MUCH!!!

Very good paper Nick.
In addition may I suggest the following 3 strategies.
8. Invest heavily in healthcare facilities for contagious disease. Corona, dengue, flu, etc.
9. Invest and encourage remote learning, work at home, and other Internet based tools.
And most important _
10. Teach everyone how to cure themselves of covid, flu, etc. at home. Many doctors and Covid patients report success by merely prescribing pills and home based regimines.

Can we possibly add online medical pre-screening or if possible preliminary med consultation / care/ monitoring, to declog hospitals & clinics of mild cases that are treatable at home?
#9 strongly agree, for university education at home via internet while covid meds & vaccines are still being formulated & tested.

We knew from history how the conquestadors defeated, and decimated the population of the Incas in Central Americas. Yes the small pox, white peple, have that immunity, the incas dont . So we have the facts, we have graphs and tables, we have the results,. My question is what country and or community have already tried these method for the 21st century. We are in the year of the rat, and maybe therefore we can all be “LabRat”. The first country to participate., And thats very dangerous.., let the first country cometh to participate, if its successful maybe then.. will follow.., but for now wll wait for the develoment of vaccines being develop from different laboratories all over the world.,. Hopeless and unsuccessful..?,w’ll resort to Heard Immunity..

I cannot help but appreciate the effort exerted to come up with this plan. I totally agree that we cannot afford an extension of the lockdown. When people go hungry, i am afraid of the unrest that may ensue

Yes I agree for this particular sugestion, but the problem is how about like that in Ebola in Africa since that nobodies late to maintain the antidote after spread out the virus.i strongly condem, fatalities will be more to come out.

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I totally agree to this open letter. I am from the dairy industry. Our beloved leaders hav imposed very strict rules to keep the population imprisoned in their own homes. As they say” better safe than sorry” ! This quarantine is only good for a prescribed period, not to get the virus but at the same time being able to survive financially. In agri-business for instance can we stop feeding our livestock without farm personnel? Those checkpoints are already practicing martial law at this time! Our trucks are prevented from travelling to fetch feeds or grasses for dairy cows. How can an SME afford truckloads of 10 wheelers for feed cargo? This is what our provincial govt has ordered. All because THEY WANT TO IMPOSE MORE STRINGENT RULES!

This approach will address both problems health and economy. They are intertwined in the first place. It is is not either/or. We just need to understand the situation better. Praying that the advise he will heed too will be coming from a higher being.

The pendulum must swing somwhere in the middle of two extremes. We just need to fine-tune the adjustments as we go along. Time is of the essence. Obviously, the open- letter is a very way to start. I endorse its full consideration by the IATF.

In principle, this is true. But, I don’t think this herd immunity approach will favor our country. This will just expose our already poor healthcare system to patients numbering into tens of thousands and leave our hospitals to be overwhelmed. Certainly, there will be more death. Mind you, these fatalities are not just statistical figures. They are fathers and mothers and sons and daughters whose lives we can no longer bring back. And, we cannot afford to lose many more.

The inclusion of “tele-health” must now be part an integral of the nation’s healthcare delivery system. Access to care is a very important pre requisite of therapeutics. Systems and guidelines must be established.

For all the data & statements mentioned above, the only comment I can offer to the Prez, it’s a choice of lesser evil.. how, pls bear w/ me.. whether he chooses the a continued quarantine, say, ECQ for total Luzon, the hardships Pilipinos have been experiencing due to dwindling money and foods, it’s just a matter of time when more people will take to the streets. If he chooses selective quarantine for reasons provided above, businesses of essential goods can employ back, pinoy can now provide money & foods for his family. Either way, there will still be death around but pinoys will now learn how to follow the rules to avoid the virus.

Truly this Proposal if Implemented can really Outsmart most if not all our Neighboring Countries.

However Let the Introduction of the Final, Potent and Tested Vaccine be Available in the Market and Hospitals Nationwide… So that the Wise principle of “Striking a Balance” Between two Opposing Rationalities be Both Accomodated and the Chosen part or portion that is implemented will be clearly identified over the “Thin Line” and be Fairly Justified and thereby any Detrimental Risk factors be will be fully addressed at a “Controlled Risk” rather not ending thru Damage Contolling.

This ex-mayor president only knows how to kill his enemy. He doesn’t listen to anyone. In fact, mumurahin nya lang anyone who will advise him. Filipinos deserve Duterte as their incompetent leader. I really wish that he will take the advise of this open letter but I wouldn’t put my hopes up.

We continue to hope for the best. Please join us in envisioning/mentally-recreating the positive response of the president, as well as receptivity and understanding among all the members of the IATF. We know that all Filipinos, both government officials and private citizens, wish to find the best possible solution to the COVID-19 dilemma.

A big thank you Mr Nick Perlas. Very good analysis of the situation coupled with smart proposal. I strongly agree and I hope this will reach the addressee for consideration. If I may suggest, Media outlets should be furnished as they can help bring this to proper authorities. Thank you.

Hello, this is Sarah, the website admin. Thank you for your comment. Several local media outlets have picked up this story, we shall be posting some of the interviews Nicanor has done in line with this open letter.

Please continue sharing the letter and the briefing paper so it can have the widest reach. It is our hope that a public discussion can begin regarding COVID-19, the role of our own immune system, and, a new understanding of health.

This is indeed an interesting dissertation and proposal. How do we reconcile the fact that we have not tested a relevant number yet? From the start, up to April 18, only~60,000 tests done. How can we reconcile the fact that we are prioritizing our tests to the “most likely” only? To say that the number of cases are going down without having tested thenright number and the right population is scientifically premature.

We totally agree to your open letter, Mr. NICK PERLAS and to the positive comments of those who replied, we are manufacturers of geotextile nets and cocopeat used as fertilizers in growing vegetables based in Agdangan, Quezon Province, since the lock down started, we tried very hard to be self sufficient, followed implemented rules but with no sales and deliveries our financial resources is down the drain, to help a little with finances, our stay-in staff in the factory does a little work here and there, problem is the LGU’s, Barangay Officials in the place stops the operation and movement inside our factory which is in a private property,
I cannot understand Why? Is this an order from the provincial government, they should be flexible,
ours is a necessity, MR. PRESIDENT, WE KNOW HOW HARD TOUGH DECISIONS YOU HAVE BEEN MAKING BUT PLEASE LET ALSO THE FILIPINO PEOPLE HELP THEMSELVES TO PROVIDE FOR THEIR OWN, FILIPINOS ARE RESOURCEFUL BUT WITH TOTAL LOCKDOWN THEY CANNOT MOVE, IF THEY GO HUNGRY THEY MIGHT TURN TO SOMETHING NOT GOOD

This should be implemented right away if found effective. I myself will abide by this. And I hope the entire nation will do. We need to move on with our lives. We cannot stay in our homes forever. We will die with paranoia and hunger.

Well researched paper. We pray it reaches President Duterte and the IATF. Agree.
We need to work fast. The early seniors, 60-75 are still quite productive and health prudent. They should be able to contribute. Much work has to be done about massive communications. Many of our countrymen have to educated quickly and massively about these measures, particularly all LGUs and Barangays.

HOW A LOCKDOWN GENERATES BENEFITS, BUT TRIGGERS HAVOC
A Special Report by Michael M. Alunan

There are many reasons why the Philippines can knockout the dreaded Covid-19 virus sooner than feared, and even save thousands of lives from other diseases resulting from poor hygienic practices, but if the lockdown drags on too long , it may trigger the worst socio-economic havoc.
Our draconian response to the corona virus through a “lockdown,” euphemistically called “enhanced community quarantine,” will contain the virus, but will also trigger positive and negative unintended consequences.
Local diseases kill thousands more. The paranoia is understandable as there is no established cure yet. Secondly, although less fatal than SARS or MERS, it is more contagious, making it “worse” and now a global pandemic. Thirdly, as it has gravely affected Western countries more led by US, Italy and Spain, which have triggered the Western-dominated media to magnify the issues, but ignoring other health issues.
Scores of thousands of Poor Filipinos also die yearly unnoticed from similar diseases and other ailments because of poor hygiene, and the lack of toilets and water, and poor garbage disposal systems. But these are ignored as they affect only Poor communities.
Worse is our callousness for tolerating these deaths due to ignorance and utter neglect, considering these are all curable and preventable.
This callousness is ironic and lamentable as we have been blinded from seeing the stark reality of thousands of deaths right before our eyes, while we shudder more at the thought of an invisible enemy invading us. This only manifests our colonial mentality and the strong influence of Western media.
Imagine, for TB alone, also a contagious disease long-eradicated in developed countries, over one million Filipinos are active with TB, making us the top 3 in the world. In 2018 alone, 22,103 Filipinos died of TB, records of the Dept of Health (DOH) show.

OVER 100,000 DIE OF RESPIRATORY DISEASES.
Even Health Secretary Duque declares they will locate and treat 2.5 Million Filipinos with TB from 2017 to 2022. Pneumonia even killed more, about 56,815 in 2018. Another 24,820 died from chronic lower respiratory infections, or a total of 103,738 deaths from curable and preventable respiratory diseases, DOH statistics said which can be validated with the World Health Organization (WHO), and other global institutions.
Other top 10 leading causes of deaths linked to poor hygiene and garbage disposal systems and the lack of toilets and water, are digestive diseases like diarrhea and gastro-enteritis, which claimed 22,803 lives in 2016; and genito-urinary diseases, claiming 23,526 lives.
The deadlier diseases are of the heart, diabetes, etc., but these are problems of more well-fed people due to obesity, too much food, sweets, etc, They can simply cut down on gluttony, but what must be given due attention are the diseases afflicting the Poor as a result of hunger, malnutrition, and poor toilet-water systems.

9M DIE GLOBALLY FROM HUNGER YEARLY.
World Counts.com, a website consolidating data from world institutions reports that around 9 million people die every year of hunger and hunger-related diseases. This is more than deaths from AIDS, malaria and tuberculosis combined.
On respiratory diseases, WHO says 3 million died from Chronic obstructive pulmonary disease (COPD) in 2016; 3 million from lower respiratory diseases, including bronchitis and asthma; and 1.3 Million from tuberculosis (TB). Why there is no attention from media and global leaders is mainly because victims here are considered Poor and dispensable by the indifferent global elites of this world, which smacks of tolerance for Malthusian genocide.

PONTIUS PILATE’S ACT?’
Certain oligarchs of this world, who may wash their hands of any responsibility with this explicit neglect, is a classic Pontius Pilate act that led to Jesus’ execution. But what is also favorable with the massive “lockdown” is the awareness raised on the importance of what WHO recommends—-washing hands with soap, which we can also dub jestingly and literally as a “Pontius Pilate” act. If social distancing is unavoidable, people must learn the science behind washing hands with soap. More so, as many poor Filipinos lack utensils and eat with their hands, and don’t also use serving spoons, which aggravate contamination.
A Michigan University study says only 5% of Americans wash their hands after using the toilet. More so, Filipinos in poorer communities, where water systems and toilets are lacking.
With massive awareness on hygiene like washing hands, and physical distancing, deaths from diseases like diarrhea, TB, etc. can drop massively. The Duterte administration can take full credit for this unintended achievement, and should “not wash its hands” idiomatically over the responsibility for taking bold decisive actions.
These potentials, however, may be negated, if the lockdown drags on too long and the economy slumps, triggering pockets of hunger that weaken people’s capacity to resist all forms of diseases.

PROBLEM IS GETTING TOO BIG?
But the success of reducing deaths can happen effectively only if the “Build, Build, Build” infrastructure frenzy is also directed at building water systems and public toilets. Ayala’s Manila Water, Many Pangilinan’s Maynilad, and the local water districts, many now taken over by Manny Villar’s Prime Water, can be tasked to do this with costs padded-on rates.
Water.org reports that seven million out of 105 million Filipinos, do not have access to safe and sustainable water, or “TUBIG” in Pilipino, while over 24 million lack toilets. UNICEF adds that three out of 10 health care facilities in the Philippines lack clean toilets

LITTLE DISEASE EXPOSURE BUILDS IMMUNITY?
Unlike Italy, which has the highest aging and vulnerable population in Europe, Filipinos are constantly exposed to contagious respiratory diseases, which must have developed immunity in many Filipinos.
Despite our massive exposure to Chinese tourists and POGO workers, the spread has not spiked-up and has not reached the hoi polloi or masses on a mass-scale. Most cases come from middle to upper classes, exposed to travelling tourists and traders.
American-British-Israeli bio-physicist and Nobel laureate in chemistry Michael Levitt of Stanford University asserts that even without treatment, a number-crunching analysis shows declining incidence and falling death rates, at least in China, Korea etc., but still on the rampage in America and some countries in Europe.
China, which started it all, has zero or nil new cases and deaths with total number of cases at 82,778 cases and deaths at 4,632 as of April 22, is now down to No. 8. What remains alarming are the US, now topping the list with 819,164 cases and total deaths of 45,340; Spain in No. 2 with 204,178 cases and 21,282 deaths; Italy, sliding down to No. 3, with 183,957 cases and 24,648 deaths. Philippines had 6,599 cases and 437 deaths. (Please update figures by press time)
Apparently, at the average global mortality rate of 3.4%, although Italy is extremely higher because of its peculiar demographics of aging patients, conversely the global survival rate is 96.6%. As many Third World countries have not shown spikes in cases and deaths, perhaps, it is because of their higher younger population. In contrast, China, Italy, Spain have higher deaths because of their high aging population, and in China’s case, a result of over four decades of its one-child policy.
In short, while we worry and focus over mortality and confirmed cases, what we ignore to analyze are the faster multiplication of survivors, and probably bigger still those turning immune. Assuming that even if everyone is already a virus-carrier, but if all turn immune, it no longer matters.

HOPE IN “RISK-STRATIFIED” MEASURES?
Israeli Defense Minister Naftali Bennet asserts that the best strategy better than physical distancing, testings, etc. is simply isolating older people.
Dr. David Katz of Yale University’s School of Public Health, is against total lockdowns, but calls for precision “surgical strikes.” He also recommends “quarantining only the most vulnerable-” older people, but allows the “rest of society to return to their lives” to prevent the “economy from collapsing.”
Katz reports that the “lockdowns forced students and employees to go home to their parents and grandparents, thus increasing the latter’s risks.” He added South Korea’s experience records 99% are mild cases, and only 1% is fatal, which requires isolating only older people, and prevent younger ones from crowding out the elderly in hospitals. Obliquely, Katz and Bennet “want the pandemic to run its course” by implicitly and eerily allowing more younger people to be exposed, so more get immune, which eventually kills the virus.
Sweden’s model of developing “herd immunity” is worth exploring as it opposed lockdowns, claiming “the fastest and safest way to “flatten the curve” is to allow young people to mix normally, and spread the virus asymptomatically, while requiring only the frail and sick to be isolated.” Although it’s already a developed country, it believes a lockdown will gravely affect lower incomes.
Also worth considering seriously is mask-wearing. Countries with high mask-wearing cultures had lower deaths like Hongkong with 4 deaths; Taiwan, 6 deaths, both of which were prepared having experienced SARS; and Vietnam with zero deaths, In contrast, the high deaths for low-mask-wearing countries like Italy, Spain and USA. Czech Republic initiated the Mask4All organization and its study shows hat even home-made masks can capture 95-100% of droplets, thus preventing human transmissions. Vietnam, despite wide presence of Chinese, only has 265 cases and zero deaths. These countries requiring masks do not implement costly lockdowns.

LESSONS FROM PLAGUES IN HISTORY.
It is wise to learn from history with Jared Diamond’s book “Guns, Germs and Steel” revealing that the Spanish colonizers subjugated the Aztecs, Mayans and Incans easily because they brought unknowingly viruses, believed to have decimated 90% of the populations of Latin and South America.
Diamond asserts that Europeans, exposed for thousands of years to raising cattle, pigs and sheep, were already immune to animal viruses and diseases, having experienced numerous pandemics like the Black Death or Bubonic Plague of the dark ages, which claimed 50% of Europe’s population. So when the Spanish explorers conquered the Americas, subjugation was easy as whole villages strangely perished wherever they went.
For instance. Mexico had 22 million people in March 1520, and was down to 14 million by December because of small pox. More European diseases followed that by 1580, population was less than two million.
Today, the situation is reversed in Western countries, having developed since World War II “hygienic-clean” situations with aging populations, which have lost some immunity, making them vulnerable to viruses from the East.
Our advantages today are lessons from history, info-sharing in our global village, and the advances in science to neutralize this invisible enemy that knows no boundaries, class, gender, politics, culture or religion, but strangely spares innocent children. Children may be carriers, but it is in them where the genes of resistance and immunity can develop fast in time.

MUCH ADO ABOUT NOTHING?
Other countries like South Korea, Japan, Singapore, Vietnam, etc. have refused lockdowns, but are successful. Even China localized its lockdown to Wuhan and Hubei province, but were supported by the entire China. Europe is different having aging populations and afford to subsidize their people for months of lockdown, although Japan has similar conditions, but has not resorted to lockdowns.
What others are doing effectively is anchored on science thru tests, zeroing-in on hotspots to confirm cases then contact-tracing, which Singapore calls basic detective work, to identify for treatment and quarantine. It is logical to make precise surgical intervention rather than taking down the hornets’ nest, and getting all to go helter-skelter in panic.
The “shock and awe” lockdown was necessary to drive the message on the need for hygiene and social distancing, now appropriately re-named by World Health Organization (WHO) as “physical distancing.” But it is an opportune situation for government to make the necessary reforms for the better.
Government must be flexible enough to adjust and back-pedal, if necessary. Harvard experts do not advise prolonged lockdowns, but recommend “shorter intermittent strategic” clustered lockdowns.
Otherwise, the risks of battling Covid-19 through long-drawn lockdowns may end up costlier like a Phyrric victory, or also aptly described as “Much Ado About Nothing” to quote Shakespeare.

WHEN WHEEL POWER GRINDS TO A HALT.
When the “Wheels of Progress” are forced to grind to a total halt because of government’s WILL power, the repercussions are tremendous. Transport, just like communications, water and power, are vital services that must be allowed, but calibrated to assure movement of people who produce goods and render services, including our frontline health workers.
If this drags on, production of food may no longer catch up with surging demand, reinforced further by panic-buying and “hoarding” by traders, who anticipate shortages and delivery lapses. Gaps may occur in some communities, where some impatient hungry irritants resort to stealing or looting, similar to what happened in the aftermath of the Typhoon Yolanda in Tacloban.
As a consultant of the NCR TODA Coalition headed by Ace Sevilla, we receive appeals from member tricycle drivers and operators for pockets of exception to survive. Cross-border transportation may be restricted, except for food deliveries and key industries, but because quarantine is supposedly community-based, tricycles are perfect for such situations. “Physical distancing” can be maintained as a tricycle driver can be separated by plastic sheets from his sidecar passenger, limited to one; while payments can be done thru containers, where touching is avoided. Both drivers and passenger can disinfectant after every ride.
There is no way for government to replace the market, where burden is distributed widely to all. Even in wars, for every combatant, you need 3-4 in auxiliary, logistics, medical etc. Even when the National Food Authority (NFA) regulated rice then, it could only inject less than 2-3 percent of the market.
Thus, even good plans, done solely by government, will be a logistical nightmare as inherent inefficiencies buildup. It will burn out government people too. Moreover, any Govt. support for the Poor, will not reach all owing to the layers of filters, which are justified privately as distribution fees, management fees, etc.
As the old saying goes, “Where there’s a WILL, there is a Way, but this does not work for all situations. Perhaps, jestingly ”If there is a WHEEL, there must be a WAY” as it is easier to roll over problems, by allowing transport mobility but with restrictions.

ONLY ONE RACE—HUMAN RACE?
As Covid-19 cuts across all geographical borders, regardless of race and nationality, implicitly it also means this can be solved if also races and nations realize there is only one global Village, and unite as
ONE RACE— HUMAN RACE.
Unfortunately, there are active remnants of the dying ideological divide between capitalism vs. socialism, or the Geo-Political Cold war between the Free World vs. the Iron Curtain and the Bamboo Curtain, Military Hawks vs. Peace Doves, etc. The “Hawks” representing the military-industrial-financial complex want to fuel wars to generate continuous markets for their military hardware. They have been opposing Pres. Trump, who finds nothing wrong making friends with arch enemies Russia, China and North Korea. Trump may be obnoxious, arrogant and guilty for his many racial, Islamophobic, and misogynist remarks, but he is anti-war, considers NATO obsolete, and wants US to stop being the world’s policeman and even spending for the military bases in rich countries like Germany, Japan and South Korea, etc. As former owner of Miss Universe beauty pageant, he made “World Peace” a popular slogan.
China is guilty of many grave charges, but it is doing something positive with its Belt and Road Initiative (BRI) now supported by about 150 countries owing to its commonly-shared mission of massive infrastructure and industrial program as a better alternative to war.
Lately, while China is implementing its Health Silk Road and providing donations to 82 countries to fight Covid19, the London-based conservative think tank Henry Jackson Society (HJS) declares to sue China for $6.5 trillion for coronavirus damages. American lawyer Larry Klayman and his advocacy group Freedom Watch also filed a $20 trillion lawsuit against China over the coronavirus. This smacks of another geo-political maneuver of the same cabal of neo-con hawks as HJS, for one, is tainted by the presence of neo-cons like former MI6 head Sir Richard Dearlove, former CIA Director James Woolsey; and many more. Dearlove alone is the originator of the failed “Russiagate” campaign against Trump and behind the Weapons of Mass Destruction hoax that Ex-Prime Minister Tony Blair peddled to get George W. Bush to invade Iraq.

IS “INVISIBLE HAND” BEHIND?
The plot thickens because as the neo-con hawks want continuous wars with Russia and China, the apparatchiks and business moguls identified with the Chinese Communist Party seem to be equally guilty. And there are increasing allegations and evidence of their collusion with a cabal of other players, which include the big Pharma industry, WHO, Center for Disease Control, the Melinda & Bill Gates Foundation, Clinton Foundation and the Chan-Zuckerberg Initiative, along with Antonio Fauci, Trump’s Health chief, who has a string of shady programs to his name, says Dr. Shiva Ayyadurai, PhD, Microbiology Engineering of MIT and inventor of the “E-mail,” who also showed proofs of this collusion. Dr. Shiva wants Fauci fired and indicted in court for being in the center of all this machination.
Perhaps, it is no wonder why Bill Gates, for one, was already warning of forthcoming pandemics every 20 years as early as 2015. Gates claims a virus can kill as many as 30 million people in a year, and has pushed for the continuous development of vaccines. World Bank also launched its $500 Million Pandemic Emergency loan in 2017.
Shiva reveals that apart from Wuhan; Fort Detrick, the US Military’s Biological Warfare laboratory, has also been the source of the virus, and that separate virus strains attacked Wuhan, Italy and Iran, but all traced their origins indirectly to Fort Detrick.
A manifestation of this collusion is the arrest this January of Harvard professor Dr. Charles Lieber, Chair of the Department of Chemistry and Chemical Biology at Harvard University, and two China nationals. There are also proofs of China conduits giving millions of grants to universities and research institutes like the $350 Million donation from the Chan family’s foundation setting up the Harvard T. Chan School of Public Health in 2014.
Apparently, the classic Adam Smith’s “Invisible Hand” is planning to pick pockets of people and loot nations on a wholesale. Dr. Shiva reveals that the over trillion dollar pharmaceutical industry worldwide has been experiencing declining markets and profits for many reasons. One is increasing costs with research & development alone per drug lasting as long as 13 years and costing $1-5 Billion each, and yet only 20% are successful in the first phase alone, and with two more phases to go before commercialization. Second is the mounting cases over toxicity and complaints from patients over side-effects. Third, is the rising shift from pharmaceuticals to Nutraceuticals and food supplements.
The only logical strategy therefore for the drug industry to bail itself out is to go mass-scale vaccination because under the law, at least in America, drug firms cannot be fully sued for vaccination, but even indemnified.

SORE THROAT AND THE SURE TRUTH.
As always, we ordinary people are fooled often by either side. Worse, it seems the antagonists on the political divide (Big business and Chinese communists) are now even ganging up together against the people of the world, not over politics but business, by making use of the Corona Virus scare and people’s fear and ignorance to swallow their propaganda.
Starting with a “SORE THROAT,” some people are scared into believing it is an early sign of Covid-19, but Dr. Shiva declares not to fear viruses as our body of six (6) trillion cells already contains 380 Trillion viruses, and 60 Trilllion bacteria.
In fact, he asserts “viruses do not harm or kill us. It is the overreaction and dysfunctional immune system to the virus that results in our own body attacking its own cells, tissues and organs—resulting in harm and death. Most of those who die, already have pre-existing problems like heart diseases, diabetes, obesity. smoking, immuno-deficiency, etc.,” which are reinforced further by dirty food, dirty water, dirty air and dirty environment.
Reports show 80% put on ventilators do not survive. Dr. Shiva explains the lungs of patients are already filled up with fluids, and pumping air thru the ventilators will only cause more damage and drown critically-ill patients.
But everyone is pushing ventilators, which cost $25,000 to $50,000 each, that even Ford and General Motors have re-tooled to produce these lucrative ventilators.
He advises instead to dextrose 10,000 I.U of Vitamin C for critical patients. Hydroxychloroquine is recommended by some doctors, but this causes 61 side-effects, Dr. Shiva says, claiming Vitamin C is better as it does the same medical benefits, but with no side effects. In the end, what he recommends is for people to get ample Vitamin D from morning sunlight, Vitamin A from leafy vegetables, and Vitamin C with zinc from supplements, all to help enhance the body’s immune system.
Also emerging as likely true why innocent young children are spared, although they become unknowing carriers and contaminate their old folks; and conversely why the elderly are more vulnerable, it is because of their contrasting levels of melatonin, which one gets from deep sleep at night in pitch-black darkness. Children sleep 10-12 hours a day and have high melatonin levels, while older adults have declining levels of melatonin, worsened further by fewer hours of sleep at night. So don’t panic when one gets a SORE THROAT, instead search for the SURE TRUTH as it will set you free and keep one healthy,
(Email: michael_alunan@yahoo.com)

Im a healthy elderly…being a well informed person i believe that our immune system is our operating system and we can make it very resilient to cope up even with an unknown invader like this covid 19..many factors come into play in taking care of our immune system, one impt of whic is ones personal expression or freedom. allowing us to go out and buy our personal necessities is a joy enhancing our immune function…we are not kids anymore. We know what is right and wrong.. thank you Dr Perlas for your insight and expression. I strongly support you..

Herd immunity is achieved after a certain portion of the population (there is scientific research that pegs it at 40%) is exposed to and infected by the virus. To achieve herd immunity by exposing the least vulnerable to the virus is sensible in that it will not spike the infection curve beyond the capacity of our health facilities, but it will necessarlly lengthen the period to achieve the desired result.

I totally agree that lockdown should be stopped. Lockdown is destroying our economy and is developing fear of death in the country as a whole while destroying our way of life. We are all locked up doing nothing in our house and we can see that there are deaths by the thousands. Death are so minimal that war with its effect is millions of times more dangerous that this fear of Covid 19 Lets simply get out and wear mask and get back to work and not stay imprisoned in our houses by doing nothing. Lets get back to work and fight this covid openly and not staying in our house because of this stupid covid.

I would like to suggest a test one family member every families to check if this family has been infected or not. For us to make a clear visibility of who has the virus or not and from then the negative families will go with the normal lives and found positive will be isolated. I am sure it will not cost all the government have now. We need to make sure we have a correct segregation of people and I am sure majority will be negative and we can then go on with our work, our natural system of living.

SC FIT TO WORK. With the pandemic, many SCs who are Consultants to companies lost their jobs. SCs can also make great contributions to Phil society and such work makes them fit, healthy and are more conscious of sustaining healthy lifestyle. The proposal of Dr Perlas is very scientific but should also consider inclusion of the SCs in the economic picture, not only in identifying our group as 1st to be protected (but thank you for this) health wise but as productive citizens as well. I have been working overseas for 9 yrs now teaching ofws on how to become more financially responsible and to set up their own enterprises while working overseas. If people like me will be locked in or locked down, we will die, not because of COVID, but because of frustration and maybe because we can’t buy our own food, vitamins and maintenance medicine… Lockdown of President Duterte is a show that his priority is saving lives and I salute him for that.. Short term pain for long term gain..

Thank you Mr. Perlas for providing this forum.
There’s a price tag for every chosen approach to this crisis, but whichever way we want to balance how much resource goes to health security & how much for the economy, the truth is we have insufficient budget. If only we could afford more.

But Billions were allocated for Highways, Skyways, Bridges, Airports & such… from pork barrel. Could we not do something about this ? It feels so insensitive & unfair to the majority.

Couldn’t we wait until our economy can once again afford this, then resume our build, build & build ?

I am very supportive of this approach. This is the first time in world history that governments have quarantined the healthy instead of the sick. We are required to stay in our house with no sun, no fresh air, little exercise and the high stress of not having income and seeing the economy crash all around. These measures will decrease intead of enhance community health. I am lucky to have resources to survive, for now. So many others don’t. All our normal health and wellness measures have been denied us. All our normal social supports have been denied us. My business cannot survive if this continues. My business is small. I am insignificant. But i am one of 100s of 1000s… i paid staff, i paid taxes… i want to get back to that. I want my kids back to school. Thank you.

I agree with you mr Perlas the President should replace some of his advisers. To lock down the entire country.more people will get sick if you lock the family of four in one bedroom. Let the people have some exercise and eat healthy foods to boost their immune system. Do not let the people become lazy by giving money without working.

To all who have given their support for the Open Letter and its Attached Briefing Paper, I just want to give our heartfelt THANKS for your postings. It gives us energy to keep on doing the work. It would be difficult to respond to all of you individually as time needed for research has to be set aside. There are larger struggles ahead. Thanks for engaging. The Truth shall set us all free from darkness and fear. And for the few who have a different perspective, I will address your concerns in due time.